CSU enters area health-care market

FORT COLLINS — Jim Smith played tight end and offensive guard for Colorado State University in the mid-1960s. He was accustomed to being in a semblance of shape. In recent years, he’s let himself slip, and he thought about an exercise program to shore up the neglect. But first, he took advantage of another program that wasn’t available until this year.

Smith checked into the Heart Disease Prevention Program, or HDPP, offered through CSU’s Human Performance Clinical/Research Laboratory, which has been open since February and was dedicated May 1.

“I work out a fair amount, but I didn’t want to get into a situation where I would blow up,” Smith said.

Of course, Smith was talking about his heart. At 54, Smith knew he was past his prime and wanted to make sure he could exercise safely.

The HDPP is the first of three planned outreach programs that will be offered at the lab in the future, said Gay Israel, who conceived the $1.8 million, 5,739-square-foot lab adjacent to Moby Arena.

“Essentially, we know what causes heart disease,´ said Israel, who heads CSU’s Department of Health and Exercise Science and serves as the lab’s executive director. The purpose of the HDPP is to help gauge an individual’s risk of having a heart attack and, if necessary, develop a strategy for avoiding it.

Physicians either refer patients, or they come in themselves. The only requirement is that they must not have been diagnosed as having a heart attack or stroke.

“My father has heart disease, and my mother has an auto-immune deficiency,´ said Ruth Lytle Barnaby, director of community development for Poudre Valley Health System. “That was my big interest for taking the program. I wanted to see if there was anything that might cause complications for me.”

For a $375 fee, the patients are put through a battery of tests — some physical, some on paper.

“It’s much more thorough than anything I’ve ever had,´ said Smith. “I think Fort Collins is really lucky to have this facility.”

Clients who enter the HDPP must go through three evaluations: a preliminary visit, a secondary treadmill exam and a follow-up session. The preliminary session is between one and one-half hours long, during which the patient is asked to turn in an information packet consisting of a personality profile and a health history, as well as the results of a blood test scheduled previously.

“The personality profile is used to determine how much stress you’re under, because stress is an important risk factor just as cholesterol, blood pressure and body fat,´ said Israel.

During the preliminary visit, patients are weighed in an immersion tank and measured by a skin-fold technique in order to determine their body fat. The tank features a sling chair in which the patients sit. “We use the Archimedes technique here,´ said Israel, referring to the famous observation by the Greek scientist that a person’s body in a bathtub will displace an amount of water equal to its volume.

At HDPP, the patient also goes through tests to measure breathing performance, lung volume, grip strength and blood pressure. A resting electrocardiogram is also taken.

Why the detail? Besides getting the most complete picture possible of a patient’s health, the information gathered by the HDPP also goes into an existing research database for the clinic. The database is used to study such things as the effects of fat distribution on cardiovascular function and the role of physical activity in reducing the risk for obesity.

“The outreach is used to give the students experience and to compile information for a vast research study,´ said Israel.

After the preliminary visit, a patient returns on a Wednesday for a treadmill stress test that determines a patient’s cardiovascular fitness. As the test proceeds, the treadmill is slowly raised to a steeper and steeper incline and patients go for as long as they are able. A cardiologist is present during the test and the patient is constantly monitored in order to stop the test if there are any difficulties.

“They can work you to exhaustion,´ said Smith.

Cardiologists with the Heart and Vascular Clinic of Northern Colorado, which pledged $50,000 to the lab, donate their clinical and research services there a half-day each week.

Agilent Technologies also gave $165,000 for state-of-the-art equipment.

The final test is a review and counseling session.

“If everything is fine, the cardiologist or the exercise technician will meet with you immediately after the test and give you the results,´ said Israel. If there are some risk factors that show up, then an exercise technician will schedule an appointment to talk with you about changes you’ll have to make in your life.

Israel goes over a coronary risk profile, which is one of the documents patients receive in their report after all the tests are done. The profile adds up all the risk factors and gives a fairly accurate picture of a person’s chances for a heart attack: The higher the score, the grimmer the picture.

“This person’s score is 26,´ said Israel. “He doesn’t smoke, which is good, and he has no family history of a heart attack, but his body fat is up, he had high blood pressure and he works with a very high level of tension. This person is about 58 years old. He’ll have a heart attack in two years if he doesn’t change some of these risk factors.”

The assessment is sobering, even scary. The point, said Israel, is that the condition was caught before the patient had the heart attack, rather than after. “Now we can recommend some therapeutics,´ said Israel. “There are blood-pressure control medicines that don’t cause impotence. He can exercise. He can work on getting his cholesterol down. You would be amazed at the effects moderate walking five times a week has on a person’s chance of having a heart attack.”

The HDPP is one of two other outreach programs Israel envisions for the clinic. The second, which he hopes to launch in skeleton form sometime in 2002, will be a cancer-prevention program that will operate much like the HDPP.

In 2003, Israel hopes to organize a model cancer-rehabilitation program for the increasing number of cancer survivors.

“The incidence of survival is going way, way up,´ said Israel. “Something like this is needed the same way as cardiac rehabilitation programs were when they were first developed. We need to be able to determine a patient’s needs and rebuild their blood cells so that they can exercise and get back into life.”

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